Culture and musculoskeletal pain: strategies, challenges, and future directions to develop culturally sensitive physical therapy care

Felipe J J Reis; Jo Nijs; Romy Parker; Saurab Sharma; Timothy H Wideman

doi:10.1016/j.bjpt.2022.100442

Culture and musculoskeletal pain: strategies, challenges, and future directions to develop culturally sensitive physical therapy care

Braz J Phys Ther. 2022 Sep-Oct;26(5):100442. doi: 10.1016/j.bjpt.2022.100442. Epub 2022 Sep 15.

Authors

Felipe J J Reis¹, Jo Nijs², Romy Parker³, Saurab Sharma⁴, Timothy H Wideman⁵

Affiliations

¹ Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil; Postgraduation Program, Clinical Medicine Department, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Pain in Motion Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: felipe.reis@ifrj.edu.br.
² Pain in Motion Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physical Therapy, University Hospital Brussels, Brussels, Belgium; Unit of Physical Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Anzio Rd, Observatory, Cape Town, Western Cape, South Africa.
⁴ Department of Exercise Physiology, School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia.
⁵ School of Physical and Occupational Therapy, McGill University, Montreal, Canada.

Abstract

Background: Pain experience has a multidimensional nature. Assessment and treatment recommendations for pain conditions suggest clinicians use biopsychosocial approaches to treat pain and disability. The current pain research is overwhelmingly skewed towards the study of biological and psychological factors including interventions, whereas, cultural factors are often ignored.

Objective: The aims of this Masterclass is threefold: (1) to discuss cultural influences on pain, (2) to provide strategies for delivering appropriate pain education and exercises in culturally diverse people with chronic pain, and (3) to present challenges and future directions to clinicians and researchers.

Discussion: Cultural factors have a relevant influence on the way individuals experience and manage health and illness. Thus, people with different cultural experience perceive, respond, communicate and manage their pain in different ways. In this aspect, the contents of pain education should be presented using different culturally appropriate examples, metaphors, images, and delivery methods that may enhance the impact of the message. Efforts should be made to produce and spread culturally adapted evidence-based materials and resources. In addition, a culturally sensitive approach may help to introduce patients to graded activities, so that they can apply these strategies in culturally acceptable and meaningful ways. Future studies should investigate the effectiveness of culturally-adapted interventions in pain-related outcomes in different pain conditions in patients with different cultural backgrounds.

Keywords: Chronic pain; Culture; Exercise; Pain; Patient education as topic.

Publication types

Review

MeSH terms

Chronic Pain* / therapy
Culturally Competent Care
Humans
Musculoskeletal Pain* / therapy
Physical Therapy Modalities